Orthodontic Treatment for a Healthy, Beautiful Smile

Crooked teeth and bite problems are often solved with orthodontic treatment. Sometimes, even when teeth look straight, the upper and lower teeth may not fit together well causing a bite problem. Braces are the most common way to correct crooked teeth and bite problems. This brochure will talk about braces and other types of orthodontic treatment.

The good news is that orthodontic treatment can lead to a healthy, beautiful smile, regardless of a patient’s age. Orthodontic treatment takes time and patience, but the end result is worth it.

Problems with crooked teeth

There are different causes of a bad bite, also called a malocclusion (mal-oh-CLUE-shun). Sometimes a bad bite happens naturally. Thumb-sucking, losing teeth too early, or accidents also can cause a bad bite.

If a bad bite is not treated, it may cause problems:

• Crooked and crowded teeth are harder to keep clean. This may lead to tooth decay, gum disease, and tooth loss.

• When teeth are in the wrong place, they may keep the jaws from developing properly. An uneven bite may make biting, chewing and speaking harder, cause excessive wear on tooth enamel, and lead to jaw problems.

Types of orthodontic treatment

There are different types of orthodontic treatment that can be used to correct a bad bite. All use constant but gentle pressure to move teeth and align jaws.

Braces

Braces consist of small brackets that are glued to your teeth. They have slots in which a wire is inserted, and the wire is held to brackets using tiny rubber bands (“ligatures”), or through a built-in mechanism that secures the wire (“self-ligating”). The wire, which is what actually moves teeth, is regularly adjusted to slowly shift your teeth and guide jaw growth in patients who are still growing. The brackets may be metal or tooth colored. Sometimes brackets are placed on the backs of your teeth, making them invisible. Braces are available for patients of all ages.

Aligners

Aligners (ah-LINE-ers) are made of clear plastic or acrylic and are worn over your teeth, placing gentle pressure on them to straighten them. Each set of custom-made aligners is worn for a few weeks. Then you get a new set to advance your treatment. This way, your teeth are slowly moved into the correct positions. Aligners are available for teens and adults.

Aligners are removable and need to be taken out before you eat, brush, and floss. Be sure to follow your instructions on how long to wear them each day.

Surgery

When jaws don’t line up, teeth cannot be aligned properly. Some patients may have an upper or lower jaw that sticks out and causes their bite to be uneven. In some cases, patients may need braces or aligners in combination with surgery to achieve a healthy bite.

Most people wear braces or aligners for one or two years, depending on the problem. Then they wear retainers that hold teeth in their new positions.

You can expect a little discomfort during treatment. But today’s materials use a constant, gentle pressure that makes treatment more comfortable for the patient.

Orthodontic treatment for children

When a child is about 7, he or she should have their teeth checked to see how they work together. If the child’s teeth or bite need treatment, it may be advantageous to get an early start. Treatment that begins while a child is growing may deliver results that cannot be achieved once the patient is done growing. Most treatment begins when patients are between 9 and 14.

The type of treatment recommended will be based on the patient’s orthodontic problem, treatment needs, and desired results. Patients will receive instructions on keeping their teeth, gums and “appliance” (the formal name for braces and other devices that move teeth and align jaws) clean throughout treatment.

Before orthodontic treatment

After treatment

Orthodontic treatment for adults

No matter your age, it’s never too late to improve your dental health and beautify your smile. Many adults seek treatment to correct long-time problems or to correct changes that happened over time. Sometimes an adult’s treatment takes a little longer than a child’s treatment.

Do’s and don’ts of braces

Do:

• Keep your teeth clean when wearing braces. Brushing and flossing remove plaque, a sticky film of bacteria that forms on teeth. If plaque is not removed regularly it could lead to tooth decay or gum disease.

• Go to all of your orthodontic appointments. If you delay any adjustments, your treatment may take longer.

• Visit your dentist for cleanings and exams. It is harder to keep teeth clean if you have braces. So having regular cleanings at your dentist’s office is important. Your dentist will also check for tooth decay, gum disease, and loss of minerals in the enamel (called demineralization).

Don’t:

• Eat foods that could get stuck in your braces or bend the wires. These foods include nuts, corn on the cob, popcorn, hard candy, ice, and sticky foods like chewing gum, caramel, or other chewy candy. Ask your orthodontist and dentist which foods to avoid.

• Eat too many sugary foods. This can lead to tooth decay around the brackets that could permanently stain or damage your teeth.

• Play sports and active games without wearing a mouthguard. A mouthguard can protect your mouth and jaw from getting hurt. Your orthodontist or dentist can suggest a proper mouthguard to wear with your braces.

Tooth Whitening for a Brighter Smile

If your teeth are discolored, tooth whitening may help. “Whitening” is any process that can make teeth look whiter. It may be safely done at home or in a dental office. It is best to talk to your dentist before whitening your teeth.

Options for whitening your teeth

Tooth-whitening options range from gentle surface whiteners to stronger ones that can also remove deeper stains. There are three main types of tooth whitening products:

Whitening toothpaste help remove stains on the surface of your teeth. They are the gentlest of the whitening options. They work using polishing action rather than chemicals and don’t have many side effects. However, they do not get teeth as white as chemical products. Whitening toothpaste can lighten teeth a little bit at a time, over days or weeks.

Several whitening kinds of toothpaste have earned the American Dental Association’s Seal of Acceptance and have been shown to whiten teeth by removing surface stains.

Home-use whiteners

come from your dentist or are sold over the counter. They may be applied to your teeth using trays, strips, as a rinse, or with a brush. They usually contain a chemical called peroxide (pur-OX-eyed), which gets below the surface to lighten tooth enamel. Home-use whiteners are meant to be used over days or weeks.

Your dentist may make custom whitening trays for your upper and lower teeth. You put the whitening gel in the trays and wear them for short times during the day or overnight. Your dentist will tell you how long to wear them. If you wear the trays for too long, the peroxide in the gel can irritate your teeth.

In-office whitening

is done in the dental office. In-office whiteners are much stronger than whitening toothpaste and home-use whiteners because they have more peroxide. They can change the color of your teeth faster than the other methods.

In-office whitening is usually done in about one hour. To help protect your mouth from the peroxide, your gum tissues will be covered with either a thin sheet of rubber or a protective gel. A light or laser may be used in addition to the peroxide.

Before in-office whitening

After in-office whitening

Side effects

Whitening treatment may cause your teeth to be sensitive to very hot or cold temperatures. Whitening may also irritate your gums for a short time. If the side effects do not go away after a few days, see your dentist.

To avoid harming your teeth and gums, always follow the product directions and all instructions from your dentist. If your teeth become very sensitive or if you get sores in your mouth, stop using the products and call your dentist.

There is such a thing as too much whitening! Do not use whitening products for longer than listed in the product directions or by your dentist. Too much whitening can make your teeth and gums hurt badly. It can even harm your tooth enamel.

It’s not for everyone

Tooth whitening is not a good choice for all people. If your gums have pulled away from the teeth in some places, whitening may irritate these areas. If you have tooth decay, cavities or gum disease, your dentist may recommend that these be treated before whitening. Also, it is important to be aware that the color of fillings, crowns, and some stains cannot be changed by tooth whitening.

Talk to your dentist about tooth whitening before you begin. He or she will do an oral exam to find out if it’s right for you.

Keep your teeth white

If you have whitened your teeth recently, they may stain more easily. To keep your teeth white for as long as possible, avoid tobacco products and stain-causing food and drinks (like coffee, tea, and red wine) for several days after whitening. Keep in mind that teeth usually return to their original shade over time. But if you can steer clear of tobacco and large amounts of stain-causing food and drinks, your teeth may stay bright for several years.

Our teeth are covered with a sticky film of bacteria, called plaque (sounds like PLAK). When we eat or drink anything that contains sugar-such as cookies, candy, soda, juice, or sports drinks-bacteria turn the sugar into acids that can attack tooth enamel. Over time, these attacks may cause tooth decay, or cavities. The good news is that there is a way to protect teeth and prevent decay: dental sealants.

Even a toothbrush bristle is too big to reach inside a groove in the tooth (magnified).

Dental sealants are an easy way to help keep teeth healthy

A dental sealant is a plastic material that is put on the chewing surfaces of the back teeth. The sealant material flows into the pits and grooves on those surfaces and acts like a barrier, protecting enamel by “sealing out” bacteria and bits of food..

That is how decay starts in the pits and grooves and cavities form. To keep decay from starting here, the dentist may recommend dental sealants.

Sealants help prevent tooth decay and cavities

Your teeth are coated with a sticky film of bacteria, called plaque. Bacteria turn the sugar in what you eat and drink into acids that can break down the hard, outer layer of teeth, called enamel. Over time, the acid can weaken the enamel and may cause tooth decay, or a hole to form in your tooth’s enamel (cavity).

Tooth decay often begins on the chewing surfaces of the back teeth. These surfaces have pits and grooves where plaque, bacteria and bits of food can get trapped. Just like in the pictures below, toothbrush bristles can’t reach into the pits and grooves, and it makes it hard to keep them clean.

Your dentist may recommend dental sealants to keep decay from starting on these chewing surfaces in the pits and grooves.

Tooth surface before a sealant is applied

Tooth surface protected by a sealant

Sealants are easy to apply

It takes only a few minutes for your dentist to seal each tooth. These are the steps your dentist may use to put sealants on your teeth:

1. Your tooth is cleaned and the chewing surfaces are prepared to help the sealant materials stick to your tooth.

2. The sealant is painted onto the chewing surface where it bonds to your tooth and hardens.

3. A special light may be used to help the sealant harden.

Sealants are smooth and you can’t feel them on your teeth. They are usually clear or white and can’t be seen when you smile or talk.

Sealants can last several years

Sealants usually last several years before they need to be replaced. Over time, sealants can come off, which means they may not protect the teeth as well. Chewing on ice or hard foods can also break down sealants.

During regular dental visits, your dentist will check your sealants and reapply them if needed.

Sealants are safe and effective

Research has shown that dental sealants are safe, and they are effective. The American Dental Association recommends that dental sealants are an important step you should take to lower your risk of tooth decay and cavities. If you have any questions, talk to your dentist.

You may benefit from sealants at any age

Sealants are recommended for children and teenagers, since tooth decay can start soon after teeth come in. But, you never outgrow the chance of tooth decay and cavities, so adults can benefit from sealants, too.

A sealant can be placed on a tooth that does not have a cavity in its pits and grooves. If a tooth is stained or has mild decay, your dentist may suggest you get a sealant, or another option may be necessary. If a tooth has more advanced decay, it will need a filling.

A sealant can be placed on a tooth that does not have a cavity in its pits and grooves. If your tooth is stained or has slight decay, your dentist may suggest you get a sealant, though other treatment may be necessary. If your tooth has more advanced decay or has a cavity, it will need a filling.

Prevention is always better than treatment! Sealants are very useful in preventing tooth decay on the back teeth and can save you money over time. Your dentist can make sealants part of your plan for a healthy mouth.

Sealant photos courtesy of Dr. Adam A. Francois.

Smile Checklist

Look in the mirror.

Do you like the way your teeth look?

Do you dislike the color of any of your teeth?

Are there spaces between your teeth?

Do you have any chips or cracks on your teeth?

Are you missing any teeth?

Do you have any crooked teeth?

Do you feel your teeth are too long or too short?

Are you pleased with the shapes and position of your teeth?

If your answers show that you might want a change in your smile, talk to your dentist about Improving Your Smile.

A great smile can be the most attractive feature of your face. A smile helps you express health, success, youth and sincerity. It is a great asset in your personal, business and social contacts. So it’s important that you are happy with how your smile looks. But if you are like many people, you may not be.

Your dentist has many different techniques to shape, sculpt, and make your smile more beautiful. With a few simple steps, you can have a smile you feel great about. And treatment may be more affordable than you think.

Example of an Improved Smile

Options for improving your smile include:

Tooth-Colored Fillings

Your dentist can use natural-colored materials to restore teeth that have cavities. Options include composite materials, such as resin, as well as lab-made porcelain inlays, inlays and crowns.

Tooth Whitening

Teeth become stained for many reasons – drinking coffee, tea or wine; smoking; and even aging can discolor teeth. Tooth whitening is a process that makes discolored teeth whiter. The bleach used for in-office (chair side) whitening is stronger than the bleach found in at-home whitening kits. Keep in mind that not everyone’s teeth can become movie-star white. Your dentist can recommend the whitening treatment that is right for you.

Veneers

Veneers are thin, tooth-colored shells that are bonded, or cemented, to the front of your teeth. They are custom-made of ceramic or composite resin, and look like natural teeth. Veneers can be used to fill spaces between teeth and to cover teeth that are stained, poorly shaped, or a bit crooked.

Braces

Braces can help correct crowded or crooked teeth or an uneven bite. Braces have become much smaller and less noticeable over the years. Brackets, the part of the braces that attach to each tooth, can sometimes be attached to the back of the tooth to make them less noticeable. Some brackets are clear or tooth coloured-which help braces blend in.

In some cases, treatment may be done without using braces at all. A series of clear, removable aligners are used to move your teeth over time. These aligners are more discreet than traditional braces.

Enamel Shaping

Your dentist can “reshape” your teeth by contouring tooth enamel, the outer layer of the tooth. When teeth are a little crowded or uneven, or when teeth appear too long, your dentist can use enamel shaping to improve how the teeth look.

Crowns

If a tooth needs more a dramatic change than veneers or enamel shaping can provide, crowns are an option. The outer part of the tooth is removed and a crown is placed over it. The crown can be made to fit in with your other teeth. It’s like a fresh start for your tooth.

First Steps to a New Smile

Once you decide to improve your smile, the first step is to visit your dentist. At this visit, you will talk about the best plan for you. If you have any signs of dental disease, your dentist may recommend treatment for this. It’s important to have a healthy mouth before starting cosmetic treatment.

These treatments and others can help you have more natural-looking and attractive teeth. What are you waiting for? Talk to your dentist today about how to make your smile the best it can be.

Baby Teeth: When They Come In, When They Fall Out

A healthy mouth is part of a child’s overall health.

Children need strong, healthy teeth to chew their food, speak and smile. Your child’s teeth also help give his or her face its shape and keep space in the jaw for adult teeth.

A baby’s teeth start to come in when the baby is about six months old. Baby teeth will later be lost one by one. This makes space for adult (permanent) teeth. By the time children are teenagers, they usually have all of their adult teeth. The last four teeth that come in are the wisdom teeth.

The charts below tell the names of the baby and adult teeth. The pictures show when each tooth usually comes in and is lost. But not all children get the same teeth at the same times. Your child’s teeth may erupt earlier or later than the ages in these charts.

The Transition

Adult teeth start to form under the baby teeth. After the baby teeth are lost, the adult teeth will come in through the gums.

Most children go through a stage when they have a mix of primary and permanent teeth. During this time the smile can look uneven, with some big teeth, some small teeth, some crowded teeth or maybe even some missing teeth. Try not to worry. Smiles often even out once all the permanent teeth are in place.

When your child is about age seven, the dentist will do a “bite check” to make sure your child’s adult teeth are coming in properly and that the back teeth are working together the way they should. You dentist may also take an x-ray of the teeth. If your child’s teeth or bite need treatment, it’s best to get an early start.

Healthy Smiles for Mothers and Babies

Good oral health habits not only help prevent problems during pregnancy, but they can also benefit the health of your baby.

Before Your Baby Arrives

Eat a Healthy Diet

What you eat during pregnancy affects the growth of your unborn child – including their teeth. Your baby’s teeth begin to develop between months 3 and 6 of pregnancy, so it’s important that you take in enough nutrients – especially calcium, protein, phosphorous, and vitamins A, C, and D.

You do not lose calcium from your teeth during pregnancy.

It’s a myth that this happens. The calcium your baby needs is provided by your diet and not by your teeth. So, be sure to get enough calcium in your diet by having at least 3 servings of dairy products per day. Or, your obstetrician (OB/GYN) may recommend that you take calcium pills to help make sure you are getting enough calcium.

Snacking and Tooth Decay

During pregnancy, you may feel hungry between meals. While this is normal, frequent snacking on sugary foods can lead to problems with your mouth.

Your mouth is covered with a sticky film of bacteria called plaque. Plaque feeds on the sugars in your snacks. They create acid from the sugars, which attack the protective outer layer (enamel) of your teeth. This can lead to tooth decay and cavities. Also, infection that can be caused by decay can spread. Either of these problems must be treated by a dentist.

When you need a snack, choose healthy foods for you and your baby, such as raw fruits and vegetables and dairy products. Visit www.choosemyplate.gov and follow your doctor’s advice.

How Pregnancy May Affect Your Gums

Pregnancy hormones can make your gum tissue more sensitive to plaque bacteria. Your gums may become red, tender, and puffy. They are likely to bleed easily when you brush your teeth. This condition is called gingivitis (jin-ja-VIE-tis) and it’s an early stage of periodontal (perry-o-DON-tal) disease. Your dentist may recommend that you have cleanings more often during your second trimester or early third trimester to help you avoid problems.

In some women, growths of tissue called “pregnancy tumors” appear on the gums, most often during the second trimester. These growths or swellings are usually found between the teeth and are believed to be related to excess plaque. They look red and raw. They usually disappear after the baby is born. Pregnancy tumors usually don’t cause problems but bleed easily, so it’s important to see your dentist.

Daily oral care is very important while pregnant

• Brush your teeth 2 times a day with a fluoride toothpaste to remove plaque and help prevent tooth decay and gum disease.• Floss or use another between-the-teeth cleaner daily. Ask your dentist or hygienist to show you how to brush and floss correctly.• Choose oral care products that display the American Dental Association’s Seal of Acceptance. This is your sign that they meet ADA standards for safety and effectiveness.

Keep visiting your dentist regularly

Tell your dentist:

• if you are pregnant or are planning to become pregnant soon.• about any changes in your health.• all of the medicines you are taking – with or without a prescription.• about any medical advice your doctor has given you.

During pregnancy, keep seeing your dentist regularly for oral exams and teeth cleaning. If you are worried about the effects any drug, treatment, or x-ray might have on your pregnancy, discuss your concerns with your dentist and physician.

Dental X-Rays are generally safe during pregnancy

Radiation from dental x-rays is low. Current guidelines say it is riskier for you to put off necessary dental treatment than to have an x-ray when you are pregnant. This is because dental disease that isn’t treated during pregnancy can lead to problems for you and your baby.

Tell your dentist or hygienist if you are or might be pregnant. If an x-ray exam is needed, your dental team will take steps to keep the x-ray exposure as low as possible.

After Your Baby Is Born

Your Baby’s Teeth

Your child’s baby (primary) teeth begin to appear about 6 months after birth. Most children have a full set of 20 baby teeth by age 3. Strong, healthy baby teeth help your child chew food easily, learn to speak clearly, and smile. They also help give your child’s face its shape.

Baby teeth can start to decay as soon as they appear

You may not realize it, but your baby’s teeth can start to decay as soon as they appear in their mouth. This can happen when your baby’s teeth are in contact with sugary liquids often and for long periods. These liquids include fruit juice, soda, and even milk and formula. If decay is not treated, it can destroy the baby teeth of an infant or young child.

Tooth care for your baby

The good news is that your child can avoid tooth decay. Here are a few simple steps you can take to keep your child’s smile healthy:

• Never let your baby fall asleep with a bottle filled with milk, formula, fruit juice or any other sugary liquid.• Never give your baby a pacifier dipped in sugar or honey.• Do not put a pacifier in your mouth to clean it and then put it in your baby’s mouth. You can pass decay-causing bacteria to your baby.•Start cleaning your baby’s mouth early.• Before teeth appear, wipe your baby’s gums with a wet washcloth or a clean gauze pad after each feeding.• As soon as their first tooth appears, start brushing your baby’s teeth 2 times a day (morning and night). Use a child-sized toothbrush with soft bristles and a fluoride toothpaste.

Plan your child’s first dental visit after the first tooth comes in but no later than their first birthday.

Think of the first dental visit as a “well-baby checkup” for your child’s teeth. This can help start a good relationship between your child and their dentist.

• Check your child’s teeth regularly.• Share information about preventing tooth decay with others who may be helping care for your child.• Getting the right amount of fluoride is best.

If you have lost some or all of your natural teeth, dentures can replace the teeth that are missing and improve your quality of life. With a little practice, dentures can make eating and speaking easier. You can smile freely without feeling embarrassed.

Dentures can be made to look like your natural teeth. There may be only a small change in how you look. Full dentures may even give you a better smile. Dentures also support your cheeks and lips so the face muscles do not sag and make you look older.

Types of Dentures

Complete dentures have replacement teeth fitted into an acrylic base. The base is made to closely match the color of your gums. If you still have some natural teeth, they will be removed before your dentures are placed.

Implant-Supported Complete Dentures

A complete denture may also be attached to dental implants, which provide a more secure fit. Implants are posts that are surgically placed in the upper or lower jaw. Properly placed implants make the denture stable and can help reduce bone loss.

Many patients find that implant-supported dentures are more comfortable and secure than conventional complete dentures. However, not everyone can get implants. Patients must be in good health and have enough bone to support the implants. Ask your dentist if you are a good candidate for dental implants.

Implant Dentures

Before

With implants and posts (abutments)

After

Immediate Dentures

Some patients may have the option to get immediate dentures. These dentures are made before the remaining teeth are removed. Once the denture has been made at the lab and is ready for you at your dentist’s office, the dentist removes your teeth and the denture is placed right away. With immediate dentures, you do not have to go without teeth during the healing time after your teeth are removed. Healing can take several months. Once healing is complete, the dentures may need to be adjusted or relined. Sometimes a new denture needs to be made.

Conventional Complete Dentures

A conventional complete denture is made and placed in your mouth after the teeth are taken out and the tissues have healed. Healing may take several months. The base of the upper denture covers the palate (the roof of the mouth). When the base of the upper denture rests against your gums and palate, it makes a seal to hold the denture in place.

The lower denture has a horseshoe shape so there is room for your tongue and its muscle attachments. It rests on the gum and bone tissues of the dental ridge. Your cheek muscles and tongue also help hold the lower denture in place.

Conventional Complete Dentures

Getting Used to Your Dentures

New dentures may feel odd or uncomfortable for the first few weeks. This is normal. Keep wearing your dentures until you get used to them. The lower one may feel especially loose until the muscles of your cheeks and tongue learn to hold it in place. You may have extra saliva for a short time. Some soreness should be expected for the first week or two. Your dentist will check on your progress and make any adjustments needed to make you more comfortable.

When you replace missing teeth with dentures, eating is easier. But, it takes practice. Here are some things that can help:

• Begin by eating soft foods cut into small pieces.

• Chew on both sides of the mouth to keep the pressure even. Avoid biting on the front teeth.

• Do not eat very sticky or hard foods or chew gum.

You will also need to practice talking with your new dentures. Try reading out loud and repeating tricky words in front of a mirror. Talk slowly to avoid mumbling or muffled speech. If your dentures slip out of place when you laugh, cough, or smile, bite down and swallow to reposition them.

When you get new dentures, your dentist may tell you to wear them most of the time. After the adjustment period, dentures should not be worn 24 hours a day. Your dentist may tell you to take out the denture at bedtime and put it back in when you wake up. Do not wear dentures around the clock because it can cause your mouth to be irritated.

Denture Adhesives

Your new dentures should fit securely, but the dentist may tell you to use a denture adhesive as you get used to wearing them. A denture that does not fit well may cause irritation, mouth sores and infection. While denture adhesive can help a loose-fitting denture for a short time, using adhesives all the time is not recommended. If your denture is loose, have your dentist check it. If you are using an adhesive, make sure you follow the instructions for use.

Caring for Dentures

• Clean your denture each day. Take it out of your mouth and carefully rinse off loose food particles. Wet your denture brush and put the denture cleaner on it. Also, brush all the surfaces gently to keep from damaging the plastic base.

• Your denture is very delicate and can break if dropped even a few inches on a hard surface. Clean your denture over a folded towel or a sink filled with cool water.

• It is best to use a special brush made for cleaning dentures, but you can use a toothbrush with soft bristles. Do not use hard-bristled brushes because they can damage dentures.

• A liquid soap can also be very effective when used with a denture brush. However, you should not use toothpaste to clean your denture. Some toothpastes have abrasive particles that can damage the denture base and teeth. Do not clean your denture with bleach.

• Rinse your denture well after using any denture cleanser or liquid. They may contain chemicals that are not intended to go into the mouth.

• Look for denture cleansers and products with the American Dental Association Seal of Acceptance, a symbol of safety and effectiveness.

• Keep your denture in water when you are not wearing it. Do not let it dry out or it can lose its shape.

• Your dentist can tell you how to care for your denture and if you should use a denture soaking solution.

• Keep your denture away from curious children and pets when you are not wearing it.

Caring for Your Mouth

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue, and palate every morning with a soft-bristled brush before you put in your dentures. This increases circulation in the tissues in your mouth and helps keep them healthy. Eating a balanced diet is also important to keep you and your mouth healthy.

You will still need regular oral exams by your dentist even if you have no natural teeth. The dental office will tell you how often you should have dental visits. During a visit, the dentist will look for signs of disease such as cancer of the head and neck. Your dentist will also check to see if your dentures fit well or might need adjustments.

Denture Adjustments

See your dentist if your dentures break, crack, chip, or if the denture starts to feel loose. Your dentist is the only one who should make repairs to your dentures. A person without the proper training will not be able to fix a denture. Do not try to adjust them yourself. This can harm both the denture and your health. Do not use over-the-counter reline materials or glues on your denture. They may contain harmful chemicals and are not a long-term solution for fixing it.

Denture Replacements

The normal lifetime of dentures is about 5 to 10 years, but this can vary widely depending on the patient. Your gum line and dental ridge will continue to change in shape and shrink even if you do not have natural teeth anymore. Over time, dentures may need relining, rebasing, or replacing. Relining is when the dentist adds new material to the underside of the denture base to fit to your gums. This could be either a hard or soft material depending on the condition and sensitivity of your gums. Rebasing is when a new base is made using the existing denture as a model. The artificial teeth from the old denture are used on the new base.

The mouth changes naturally with age. Jaws may line up differently as bones and gum ridges recede and shrink. At some point your dentures will no longer fit well and they will have to be remade. It is important to replace worn or ill-fitting dentures before they cause problems. Your dentist will let you know when it is time to replace your dentures.

Your New Smile

You are the key to your new smile’s success. These four tips will help:

• Give yourself plenty of time to get used to your dentures.• Eat a balanced diet for good health.• Practice eating and speaking with your denture.• See your dentist regularly.

Why Do I Need a Bridge?

What is a Bridge?

A bridge is a replacement tooth or teeth that fill the space where one or more teeth are missing. The bridge restores your bite and helps keep the natural shape of your face.
Before you get a bridge, your dentist wants you to know more about the steps involved. He or she can advise which type of bridge is best for you.

Why Do I Need a Bridge?

A missing tooth is a serious matter. Teeth are made to work together. When you lose a tooth, the nearby teeth may tilt or drift into the empty space. The teeth in the opposite jaw may also shift up or down toward the space. This can affect your bite and place more stress on your teeth and jaw joints, possibly causing pain.
Teeth that have tipped or drifted are also harder to clean. This puts them at a higher risk for tooth decay and gum disease.
When a tooth is missing, the bone may shrink. If that happens, it may change the way the jawbone supports the lips and cheeks. Over time, this can make your face look older.

Position of teeth immediately
after a tooth is lost

If the tooth is not replaced, other
teeth can drift out of position
and change the bite.

How Do I Replace a Tooth?

Placing a bridge usually takes more than one dental visit. On the first visit, your dentist prepares the teeth on both sides of the gap. He or she will later attach the bridge to these teeth.

Your dentist then takes an impression or an image of your teeth and the space and sends it to a dental laboratory. Technicians at the lab make the bridge. Your dentist will place a temporary bridge to protect your prepared teeth while you are waiting for the permanent bridge.

When the permanent bridge is ready, the dentist fits, adjusts and cements the bridge to the prepared teeth. This type of bridge is permanent and cannot be taken out of your mouth without a dentist’s help.

Fixed Bridge Placement

Missing tooth

Teeth next to the
space are prepared
for placement of
the bridge.

The custom-made
bridge is placed
over the prepared teeth

The bridge is
cemented into place.

Do I Need Implants?

Dental implants may be used to support a bridge when several teeth are missing. Implants are posts that are surgically placed into the jaw. Over time, the bone grows around the implants to hold them in place.

• A key benefit of implants is that they don’t need support from the surrounding teeth.

• Candidates for dental implants should be in good general health and have enough bone to support an implant. For some patients, implants help preserve the jawbone where teeth have been lost.

• Implants may be placed in one day or might require multiple visits depending on your dentist’s treatment plan.

Implant-Supported Bridge

Missing teeth

A bridge is placed on implants

After the bridge is placed

What Materials Are Used in a Bridge?

Bridges are made from metal, ceramics (porcelain) or a combination of the two. Ceramics often are bonded to a metal alloy. Your dentist will talk with you about the materials that are best for you and your mouth.

Caring for Your Bridge

A bridge can fail if the support teeth or the jawbone is damaged by dental disease. Follow these tips for good oral health:

• Brush your teeth twice a day and floss or use another between-the-teeth cleaner once a day. Brushing and cleaning between the teeth help remove plaque, a sticky film of bacteria that is always forming on the teeth.• See your dentist regularly for exams and professional cleanings.

• Eat a healthy diet.

• Look for oral care products that have the ADA Seal of Acceptance. Products that display the Seal have met the American Dental Association’s standards for safety and effectiveness.

Get the Facts About Mouth and Throat Cancer

Did you know that your dentist screens you for cancer at every visit?

Oral cancers can be deadly diseases. Each year in the United States, roughly 45,000 new cases of mouth and throat cancer are diagnosed, and about 13% of people die within the same year they are diagnosed.

Treatment may be more successful with oral cancers that are found early. Your dentist checks for these cancers every time you visit, so this is one more reason to see your dentist regularly.

This brochure will tell you some ways to lower your risk for mouth and throat cancer. And by watching for the signs and symptoms listed here, you are more likely to find the cancer earlier if you do have it.

What Are the Signs and Symptoms?

Below is a list of mouth and throat cancer signs and symptoms. Check your mouth in the mirror each day when you brush and floss. If there are any changes in your mouth or neck, or if you notice any of these signs or symptoms, contact your dentist.

Am I at Risk for Oral Cancer?

Anyone can get cancer. There are some factors that you may control – such as smoking cigarettes or chewing tobacco, heavy alcohol consumption, and exposure to the human papillomavirus (HPV) – which increase your risk of developing of developing oral cancer. Below is more information about factors that can affect your chance of developing mouth or throat cancer.

• Infection with HPV is associated with increased risk of developing oral cancers. HPV is very common and many people are not even aware that they have been infected.

• Tobacco associated risk, which includes chewing tobacco or smoking cigarettes, cigars or pipes, is affected by the amount of tobacco you use and the length of time you’ve been doing it.

When you quit using tobacco, your risk of developing oral cancer continues to go down. In ten years of being tobacco free, your risk is about the same as someone who never smoked or chewed.

• People who use tobacco products and drink alcohol have a greater chance of developing oral cancer than if they only did one or the other.

• Spending long periods of time in the sun increases your risk of developing higher risk for lip cancer.

• The risk of mouth and throat cancer increases with age. Though not always the case, it can occur more often in people over the age of 40.

How Can I Lower My Risk for Mouth and Throat Cancer?

• As part of your oral hygiene routine, watch for changes in the soft tissues of your mouth.

• Avoid all tobacco products, including cigarettes and chewing tobacco

• Avoid heavy alcohol use.

• If sexually active, practice safe sex to prevent the spread of HPV

• Eat a diet rich in fruits and vegetables

• Visit your dentist for regular oral cancer screenings.

How Can My Dentist Help?

During a dental exam, your dentist will check your face, neck and mouth for lumps, red or white patches, and sore areas that do not heal. Your dentist may check you for oral cancer visually, manually, with special screening tools, or with a combination of these methods.

Be sure to tell your dentist if you notice any changes in your mouth and/or neck. If signs of cancer are found early, treatment may be more successful.

Be aware of any changes in your mouth and throat. If you have any concerns about mouth and throat cancer, talk with your dentist. It may help save your life.

What is a crown?

A crown is a cover or “cap” your dentist can put over a tooth. The crown restores the tooth to its normal shape, size, and function. A crown can make the tooth stronger or improve the way it looks.

Why do I need a crown?

You may need a crown if you:

have a cavity that is too large for a filling

have a tooth that is cracked, worn down, or otherwise weakened

have had root canal treatment-the crown will protect the restored tooth

want to cover a discolored or badly shaped tooth and improve your smile

Crown Used to Replace a Filling

Before- Filling with decay at the edge

After- Filling replaced by a crown

What is it made from?

Crowns are made from several types of materials. Metal alloys, ceramics, porcelain, porcelain fused to metal, or composite resin may be used. When a crown is made, the material often is colored to blend in with your natural teeth.

Your dentist wants your crown to look natural and fit comfortably in your mouth. To decide which material to use for your crown, your dentist will consider many factors, such as:

the tooth’s location and function

the position of the gum tissue

your preference

the amount of tooth that shows when you smile

the color or shade of the tooth

Full porcelain fused to metal crown

Full ceramic crown

How is a crown placed?

It usually takes two dental visits to complete the treatment. When a crown is placed over a natural tooth, several steps are involved:

1. The dentist prepares the tooth by removing its outer portion so the crown will fit. Any decay is also removed. If additional tooth structure is needed to support the crown, the dentist may build up the core of the tooth.

2. An impression is made to provide an exact model for the crown. The impression can be made from a mold or by digitally scanning the tooth.

3. You will get a temporary crown while you wait for the permanent crown to be ready. This usually takes less than two weeks. While you have a temporary crown, the tooth may be sensitive to hot and cold. Avoid chewing gum and sticky foods during this time.

4. When the new crown is ready, the dentist places it in your mouth and makes the necessary adjustments.When you and your dentist are happy with how it looks and feels, the crown is cemented into place.

Before crown: Worn filling with decay under filling

Crown is placed over prepared tooth

After crown placement

Caring for your teeth

Like natural teeth, crowns can break. And the tooth under the crown can still get cavities. To prevent cavities or damage to your crown:

Brush your teeth twice a day and clean between your teeth once a day. Look for oral care products that have the American Dental Association’s Seal of Acceptance, which tells you that they meet ADA standards for safety and effectiveness.

Avoid chewing hard foods, ice, or other hard objects, such as pencils, especially if you have tooth-colored crowns.

Be sure to see your dentist for regular exams and professional teeth cleanings.

Produced in cooperation with the American College of Prosthodontists “Crown Used to Replace a Filling” – photos courtesy of John R. Nosti, DMD, FAGD, FACE, www.cosmeticdentistryofsj.com

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